Self-leveling tray for operating tables



March 27, 1956 J. PHILIPPI ETAL 2,739,858

SELR-LEVELING TRAY RoR OPERATING TABLES Filed July 13, 1955 2 Sheets-Sheet 1 i i *Y FIG. l

INVENTORS John Philippi ond George W.Robbins ATTORNEY March 27, 1956 J. PH|| |PP| ETAL SELF-LEVELING TRAY FOR OPERATING TABLES 2 Sheets-Sheet 2 Filed July 13, 1953 FIG INVENTORS zasasss f j SELF-LammeTRAYFQROPFRATING TABLES.

John Philippi and George Warren Robbins, Madison, Wis., assignors to Air Reduction Company, Incorporated, New. York, N. Y., incorporation of New York Application'luly k13,;y IQSS, Serial No. 367,426' l0 5 Claims. .letsel-1a This invention relates to surgical operating tables and similar"` medical service apparatusk and inore particularly concerns such a table which is longitudinally tiltable in toto or by sections and has associated therewith a tray for instruments or a similar device` i In the past when anfinstrument tray, commonly known 20 as the-Mayo tray, was associated with an operating'table so as to be in a iixed horizontal plane, diiculties were encountered in certain surgical operations which required longitudinal adjustment of the table during the ,operationI since the tray remained in the location in which it had een positioned until swung out of the way or until the tray was moved upwardly or downwardly. on itsstand.V It is apparent that such a fixed-position tray, when the operating table (or a section yadjacent to the tray thereof) is tilted, would under some circumstances press into the patient. In other instances', the patient would be moved away from the tray so that the most satisfactory position or" the tray for the operation being performed would not oe maintained. This kproblem was particularly notedin certain thyroid operations in which the tray is 3o located a short distance above the patient and the operating table is in the reverse Trendelenburg position, i. e. when the head is up and thebody extends downwardly at an angle. Longitudinal adjustment of the table from this position towards a horizontal position, as is some- 40 times required, caused the tray to press into the patient. In order to avoid these conditions, it was required to adjust the tray via its holding means, as above mentioned. ln making this adjustment, the scrubbed team would risk contamination upon touching the nonsterile tray holding 45 means.

The instant invention has as its primary object the solution ot' the foregoing problem and the provision of means which are suitable for automatically keeping an instrument tray always horizontallyk level and suitably. positioned in most instances both in relation to the patient and for accessibility by the operating team in operations during which longitudinal tilting of the operating table or parts thereof is required. In the preferred embodiment of the instant invention, a tray support is'rigdly connected 55 to a horizontal shaft and a support rod is rotatably connected to the shaft for supporting the shaft. The rod extends to a tiltable table section or patient-supporting structure where it is rigidly connected. A double parallelogram linkage extends between the shaft and a relatively stationary table frame andffunctions so that the tray is maintained level during table adjustments as well as accessible and yet without interference with the patient during most adjustments.

The accomplishment of the foregoing object, along with others, and the advantages and features of the invention will be apparent from the following detailed description and the accompanying drawings ola preferred enibodin ment in which:

Fig. ly is a partially cross-sectioned, side elevation of an. operating table embodying the linstantv invention and ice showing, by dashed lines, an alternative positioning of the tiltable sections of the`tab1e and the instruinent'tray its associated linkage structure;` Y'

Fig'. 2 is a partially cross-sectioned View from a point adjacent the legvsec'tion which is tilted downwardly and showsthe manner in which the tray, tsassociated 'structure, and the operating table are interconnected;

Fig. 3 is a partially cross-sectioned view, withparts omitted, of thelowest partof the linkage structurek and includes a segmentof the shaft which extends tothe Vfratriev partofthetable;`

Fig.- 4"is aipartially crosssectioned view and shows the intermediate dual sprocket'construction'ot,tlitellirrkangeL construction; Fig. 5 is a broken, partially-cross-sectioned view of the uppermost sprocket construction and tlietrayYattaching,l

means; and

Fig. 6 is a partially cross-sectional View, along the line A*AofFig.5. Referring to Fig. l, it can beseen that the operating table has a pedestal l), a table adjustingfinechanism M attached to the top ofthe pedestal, and 'a sectioned' table T above vthe adjusting mechanism. An instrument tray I is shown above the patient-receiving part'of'thetablej'l,

with a support rod R extending between atray bracket holding the edge of the tray' and an edge'of asecztionofj' A double parallelograrn structureSextends" the table. p u from the tray bracket to a bracket elerne'nt which i'sj attachedto the frame part of the'adjusting'niechanisrnlll of t' i,.v.\ u, 5\...,..

The table, shown schematically on the drawings and' herein described, is the'subject'rnatter'bia 'copendiu'gl application (Serial No. 99,944j ledflune 11851949,"now:`

Patent No. 2,700,583, granted "innanzi s, by?

Robert P. Davis and lohn"Philippi;"assigned.`to the' assignee of the instant invention). The 'instant descripf" tion and drawings include' only that basic structure which directly pertains to the instant invention. Reference fto the above-mentioned application may be triade yf details. lt is to be understood that the instantginyen'tionis 'inno manner limited to use withv the partcula y disclosedin the aforementioned applic y can be used with anyv table coriiprisedjo fiat least "tw' longitudinally adjustable sections, 'or'jany tablefwhich' is tiltable longitudinally in toto. Thus, ltheinstant inverttion can beu'sed with certain obst t l K I i lng tables which are used in* activ vit'ies which require changing the position ofzthe'patient and 'require that items`,`

such as instruments, remain accessibleiand'secure 'orthlat materials such as X-rays remain convenientlyy obfsevrv'alile'. The expression, a' medical service table or .device is intended to refer to any one"ofthesez'various tables,V

including` operating tables, or any' structure on which' a patient is'suppor'ted orreceived for medical `treattirent,v The illustrated,operatingtable'is typicalioffthe 'tables with which the elements andarrangenrent's liereindisclos cari be combinedtotorm' ernbodirnlentsfo'fjthefinstant. 11,11-,A vention. The illustrated operatin'gltabl ris' tiltablev longi-` tudinally both in ltoto and by sections to' give rep'ositioti ing'of 'a patient. Means" (inotshown) areprovidedfin mechanism M for tiuing'n'oth the mechanismandjthetable' 'I in toto longitudinally about a' horizontal axis 11,'forriiec'l'y at a connection between the'v mechanisinandfthe topl'of' frame member 13 which is 'attached't'o the topiofthe pediy estal P. Other means within mechanisrn M: andjextcircling therefrom to the back section 1 S,"thfe's`featsection 17,'i1d", the leg section 19 of thetable' T irefl'flljableofl tilting` the`v respective sections longitudinally. These lthei Inean indicated schematically at' 21, 23 'and '25'v the'instantinventionwtth'clarityQ yM j areA shown with connections"extending'to the respeotiv p sectio's 'to' indicate'tha't lthe 'afoenientiohed `flongitliifl petatinaltable ton'buti' Yrathery cal .tables or' eXt-'tnii'nadjustment can be made. As disclosed in the aforementioned application, suitable control mechanisms are provided and include such elements as crank 27 and selector knob 29. With this arrangement, it is possible to tilt the table in toto or to tilt individual sections, individually or jointly, to various positions.

Other adjustable operating tables which are capable of being incorporated into the combination of the instant invention are shown in U. S. Patent No. 2,520,455, issued on August 29, 1950, to I. S. Clachko, and U. S. Patent No. 2,172,941, issued on September 12, 1939, to W. H. Manning et al.

It is to be understood that it is conventional to have a head rest attached to the free end of the back section and a foot rest attached to the free end of the leg section 19. Such conventional structure. has not been shown in the interests of clarity in presenting the instant invention.

In the illustrated preferred embodiment of the instant invention, the instrument tray I is mounted in tray support 31 by means which will be described hereinafter so as to be rotatable in a horizontal plane. Support 31 has depending extensions 33, 35 forming a yoke 37 (see Fig. 2) which is rigidly connected to horizontal shaft 39 by pins. The end of this shaft 39 appears in Fig. 1 since it extends through uppermost sprocket housing 41.

The support rod R which extends downwardly in line with the vertical axis of the tray support 31 (in the full line showing in Fig. 1) is rotatably attached, at its upper end, to horizontal shaft 39 by means which will be described hereinafter. The lower end of. rod R is adjustably but rigidly held by holder or side rail clamp 43 having handle 4S. YHolder 43 is slidably mounted on side rail 47 which is attached to the side of back section 15 of the table T. It is to be understood that the side rail clamp 43 can be mounted on the side rails of the other sections of the table and thus provide for other positionings of the tray. With this arrangement, it is to be noted that shaft 39 is maintained a xed distance from the side rail clamp 43; and, as a consequence, the tray will be maintained removed from the table to an appreciable degree during many tilting adjustments.

The means for maintaining the tray horizontally level during adjustments, such as adjustment to the chair position shown by dotted lines in Fig. l, includes the doubleparallelogram structure or linkage S. The uppermost part of this linkage is the previously-mentioned sprocket housing 41. The housing 41 has two tubes 51, 53 extending downwardly at an angle therefrom. The other ends of tubes 51, 53 are connected to the outer, middle sprocket housing 55 which has shaft 57 extending therethrough. Housing 55, as well as tubes 51, 53, are partially broken away in order to show the interior structure. Another sprocket housing 59 is mounted on shaft 57 and is located interiorly of housing 55. A similar pair of tubes 61, 63 extend from the inner middle sprocket hous. l

ing 59 to the lowest sprocket housing 65 which, along with tubes 61, 63, is shown broken away in part. Each of the tubes has an adjusting arrangement 64 midway therein which provides the means for properly tensioning the chains which move over the sprockets. This arrangement is Vprovided by having each tube comprised of two segments joined by an interiorly-threaded nipple. The lowest sprocket housing 65 has a horizontal shaft 67 extending therethrough. This horizontal shaft 67 is supported by bracket 69 which in turn is rigidly mounted on previouslymentioned frame part 13. It is to be noted that part 13 is not one of the telescoping elements of the conventional pedestal P.

Other elements of the linkage mechanism or structure S include the two separate, upper and lower bicycle-type chains 71, 73 which respectively extend between sprockets in housings 41, 5 5 and between sprockets in housings 59, 65. These various sprockets are shown in greater detail in Figs. 3-5 wherein the parts ofthe chains which contact the sprockets 75,77 and,79, ,81 have been omitted.`

Figs. 3-5 also show how each socket is pinned by pins 82 to the respective shafts and how access to the sockets is provided by sprocket housing plates 83. It is also apparent that each housing is freeto rotate on the respective shafts. y

Referring to Fig. 2 which is an end elevation showing of thetable viewed towards the leg section which has been lowered from thehorizontal position of Fig. 1 with the result that it conceals the end of the mechanism M, it canbe seen that the edge of the tray I is retained in a groove in rotatable bracket 84 by a spring clip 111 which is urged downwardly by hand screw 85, threaded into the bracket 84. Fig. 2 also shows how the support rod R is clamped, as above-mentioned, to the side rail 47 since the structure in this figure has been broken away and crosssectioned at this location. In the bottom portion of Fig. 2, the previously-mentioned cross shaft 67 and the bracket 69 v for supporting this shaft are shown. Two locking screws 86 extend through the arms of bracket 69ja'nd lock the crossl shaft, and hence lowest sprocket mounted thereon,

by a pin, against rotation.

The showings in Figs. 5 and 6 illustrate how rod R is rotatably mounted on horizontal shaft 39. This mounting is effected by means of the short horizontal tube which is attached to the top of the. rod R and is positioned between the legs of the yoke 37 of support 31. Shaft 39 extends through the left leg 33 of yoke 37, then the aligned tube part of rod R, and finally right leg 35 of yoke 37. It is to be noted that both legs 33, 35 are rigidly attached to shaftV 39 rby pins so that rotation of shaft 39 causes tray support 31 to rotate.

Fig. 5 also shows how tray I is rotatably mounted in support 31. A lower edge of the tray I lits into a channel of bracket 84 which is comprised of collar 91 and center element 92. Center element 92 is attached to collar 91 by pin 93 and has an integral depending cylindrical shaft 94 which is spring-tensioned and retained in support 31. This spring-tensioning and retention of vertical shaft 94 is effected by means of spring 99 and collar 101. The collar 91a1so has an integral, supportarm 103 which extends horizontally under the tray I. The tray I is retained in the channel of collar 91 by spring clip 111 one end of which bears down against a projection 113 extending up from center element 92. Spring clip 111 has exerted therein a downward force due to hand screw 85 which passes through clip 111 and threads into an axial hole in center element 92, as above mentioned. From the foregoing it is apparent thatattaching means have been provided' for reliably supporting an instrument tray in a rotatable manner and in a manner which permits rapid attachment and detachment.

It is to be noted that the lower bracket 69, attached to the table frame 13, and the lower cross shaft 67 are so constructed, as shown in Fig. 2, that the linkage mechanism can also be mounted on the right side of the table, as viewed in Fig. 2. This is possible because the bracket and cross shaft permit the cross shaft to extend the same distance to the right as it does to the left. It is obvious that the' tray, linkage mechanism, etc. can be mounted on the right side of the table merely by disconnecting various structures such as clamps 43 andv 86. Y

The initial step in utilizing the operating table'and instrument tray shown on the drawings comprises positioning the tray at the desired height above the table by movingl support rod R and then fastening the side rail clamp 43 Yby means of its knob `45 in order to rigidly tix the rod R to the table section. Next the tray is leveled by unscrewing lower cross shaft locking screws S6 and moving the tray to a horizontally level position. Since tray support 31 is attached by pins to upper shaft 39, it will rotate, depending on the movement of the tray. Since sprockets is also fixed to shaft 39, it will correspondingly rotate, causing movement of chain 71, sprockets 79,

l 77, chain 73, sprocket 81 and lower cross shaft 67.

When the tray is so leveled,`-locking screws 86 are locked-v and hence cross shaft and the lowest sprocketlare fixed in a nonrotatable manner.

During longitudinal tilting of the illustrated table in toto or during longitudinal tilting of the body section of the table (to which section the tray support rod R is attached in the showing in the drawings), the instrument tray is self-leveled by the two parallelogram linkages and the interconnecting structure while, at the same time, suitable positioning of the tray in respect to the patient and the operating team is provided in most instances. This functioning results in the following manner. Since the lower sprocket 81 is lixed due to its pin 82 and the tightening of screws 86 on the lower cross shaft 67 and the rod R retains the upper cross shaft 39 a fixed distance from the edge of the body section of the table, it can be appreciated that, when the body section is moved to the position indicated by the dash lines in Fig. l, the action of the double parallelogram linkage (as its legs assume a more acute angle in relation to each other) will cause shaft 39 and the tray support 31 attached thereto to rotate counterclockwise and so maintain the tray level. As the instrument tray and links are displaced by positioning the table or the support rod in the side rail clamp, the intermediate sprockets 77, 79 and the uppermost sprocket 75 feed out and take up chain so that they always remain xed in relation to the positions they assumed when the instrument tray was leveled.

Although the foregoing description concerns an instrument tray, it is to be understood that the structural combination of the invention has utility in holding other items or materials in connection with medical service apparatus. Thus for example, if it is desired to hold an X-ray for observation, a universal joint and an X-ray holder can be substituted for the tray and tray holding means. With this arrangement, the X-ray can be angled so as to be suitable for observation and it is apparent that the instant invention will maintain the X-ray at such angled position during examinations in which the table is tilted longitudinally. When considered in this aspect, it is to be noted that the double-parallelogram linkage with its two connections to the table constitutes means connected to the table frame and to the patient-receiving table structure which maintains the holding means at a predetermined angle in relation to a fixed vertical axis. Thus, this structure keeps an instrument tray horizontal with respect to the vertical axis of the pedestal or keeps an X-ray picture at an angle, such as a 45 degree angle, to the same axis after the patient-receiving table structure is tilted.

It is to be understood that certain changes and modications of the specific structure herein disclosed can be made by one skilled in the art without departing from the invention defined by the claims which follow.

We claim: l

1. A medical service apparatus combination comprised of a medical service table having patient-receiving structure which is longitudinally adjustable, holding means connected to one side of said patient-receiving structure, said holding means being positioned in a plane having predetermined angular relation to a vertical axis, and means connected to said holding means for maintaining said holding means in planes having the same predetermined angular relation to said vertical axis when longiof said structure by connections including a support rod,

' and means connected to said holding means for maintaining said holding means in planes which have a fixed angular relation to a vertical axis during longitudinal adjustment of said structure.

3. A longitudinally adjustable operating table combined with an instrument tray and means for maintaining said tray horizontally level and spaced from said table during longitudinal adjustment, said means comprising a support rod connected at its lower end to said longitudinally adjustable table in a nonrotatable manner and connected at its upper end in a rotatable manner to a shaft, a trayreceiving support device connected to said shaft in a manner vwhich causes said bracket to rotate with said shaft, a double parallelogram structure connected to said shatt and arranged in relation to said table so that, when said table is longitudinally adjusted, said instrument tray will remain level.

4. An operating table including at least two sections which are tiltable longitudinally with respect to each other, a rigid vsupport member adjustably connected at one end to one of said sections and the other end of said rigid member rotatably supporting a horizontal shaft, a support device having a vertical axis rigidly attached to said horizontal shaft, a linkage mechanism connected to said horizontal shaft, and said linkage mechanism including means for maintaining the vertical axis of said support device in vertical planes during longitudinal movement of said section to which said rigid support member is connected, whereby said support device can be used to carry an instrument tray and to maintain itin horizontal planes.

5. In a medical service apparatus having a patientreceiving structure which is longitudinally adjustable, the improvement comprising a horizontally-disposed instrument tray spaced upwardly from the plane of said structure by means of a vertically-adjustable support rod which is connected to said structure, mechanical means connected to said tray and actuated by longitudinal adjustment of-said structure for maintaining said instrument tray horizontally-disposed, said mechanical means including an adjustable vertically-disposed double-parallelogram device, said medical service apparatus including a frame part which remains lixed in relation to any longitudinal adjustment of said structure and one end of said doubleparallelogram device being connected to said frame part.

References Cited in the tile of this patent UNITED STATES PATENTS 133,087 Dummer Nov. 19, 1872 173,706 Woolson Feb. 15, 1876 315,246 Cobb Apr. 7, 1885 689,707 Davis Dec. 24, 1901 1,956,546 Froelich Apr. 24, 1934 2,547,382- Freeman Apr. 3, 1951 2,550,306 Soper Apr. 24, 1951 

